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C. M. E. Deuter, D. Doycheva, B. Schoenfisch, I. Koetter, F. Gelisken, H. Jaegle, N. Stuebiger, M. Zierhut; Predictive Factors for Development of Visual Acuity in Patients Treated With Interferon Alpha for Chronic Uveitic Cystoid Macular Edema. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5258.
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© ARVO (1962-2015); The Authors (2016-present)
To identify predictive factors for the development of visual acuity (VA) in patients who were treated with interferon (IFN) alpha for chronic cystoid macular edema (CME) due to uveitis.
Retrospective analysis of an interventional case series. IFN alpa-2a was administered at an initial dose of 3 or 6 million IU (depending on bodyweight) per day subcutaneously. Afterwards IFN alpha-2a was tapered to the lowest maintenance dose to keep absence of CME. Patients had to complete a follow-up of at least 6 months after initiation of IFN alpha-2a. Control of treatment efficacy was performed by OCT. Improvement/worsening of VA was defined as a decrease/increase of at least 0.3 logMAR. Univariate analysis of possible predictive factors was followed by formulation of a regression model for VA after 6 months of IFN alpha treatment.
42 eyes (22 right eyes, 20 left eyes) of 27 patients (9 male, 18 female; mean age 51.4 years, 19-74 years) with chronic CME (mean duration 54.1 months, 6-132 months) due to non-infectious anterior (1 patient), intermediate (22 patients) or posterior (4 patients) uveitis were analyzed. Ineffective pre-treatment consisted of systemic corticosteroids and acetazolamide (all patients) and at least one additional immunosuppressive drug (22 patients). Within 6 months IFN alfa-2a lead to complete resorption of CME in 35 eyes (83.3%), to incomplete resorption of CME in 3 eyes (7.1%) and showed no response or recurrence of CME in 4 eyes (9.5%). VA improved in 17 eyes (40.5%), remained stable in 24 eyes (57.1%) and worsened in 1 eye (2.4%). If VA improved, no further improvement was observed later than 6 months after start of IFN therapy. In the regression model the factors VA before IFN treatment and duration of CME were significant, whereas the factors diagnosis, age at initiation of IFN therapy, gender, and foveal thickness before IFN treatment seemed not to be that important for VA development.
Final VA will be reached within 6 months after start of IFN treatment. VA before treatment and duration of CME seem to be the most promising factors for predicting development of VA in patients treated with IFN alpha for chronic uveitic CME. Further studies will be necessary to concretize this effect.
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